MedicaidCoverageMedium impact
5160-36-03 - Medicaid funded program of all-inclusive care for the elderly (PACE) eligibility. (New/Final File)
Ohio Medicaid·OH · Geriatrics, Family Medicine, Internal Medicine·Enrollment
Effective date
Nov 5, 2023
We identified it
Jun 20, 2026
Summary
Ohio has finalized new rule 5160-36-03 establishing Medicaid eligibility requirements for the Program of All-Inclusive Care for the Elderly (PACE). This creates a comprehensive care program for elderly Medicaid beneficiaries requiring nursing home level care but who can remain in the community with coordinated services.
Action Required
By November 5, 2023: Billing teams in Ohio should review PACE enrollment eligibility criteria for elderly patients who may qualify for this comprehensive care program. Update patient screening processes to identify potential PACE candidates and establish referral protocols. This affects how Medicaid services are coordinated and billed for qualifying elderly patients.